scholarly journals Japan’s New Framework on Dementia Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 385-385
Author(s):  
Kenji Toba
Keyword(s):  
Cognitive Impairment ◽  
Justice System ◽  
Dementia Care ◽  
Taxi Drivers ◽  
Age In Place ◽  
People With Dementia ◽  
Working People ◽  
Person With Dementia ◽  
Retail Shop ◽  
New Framework

Abstract The number of people with dementia in Japan is ever-increasing. In 2020, 6 million people lived with dementia. The number is expected to increase to 9 million in 2040. This means that a person with dementia will be supported by three working people. To prepare for the big wave of dementia, Japan released the New Orange Plan in January 2015. In 2019, the Framework for Promoting Dementia Care was issued by the Japanese cabinet in which prevention and the opportunity for persons with dementia to age in place were set as the main goals. This framework requires all ministries to promote people’s awareness about individuals with cognitive impairment. The educational targets include taxi drivers, retail shop clerks, bankers, police, and people working in the criminal justice system. I will discuss the New Framework which has potential to assist the country in supporting people living with dementia.

scholarly journals Personalisation, customisation and bricolage: how people with dementia and their families make assistive technology work for them

2018 ◽  
Vol 39 (11) ◽  
pp. 2502-2519 ◽  
Author(s):  
Grant Gibson ◽  
Claire Dickinson ◽  
Katie Brittain ◽  
Louise Robinson
Keyword(s):  
Technology Use ◽  
Dementia Care ◽  
Assistive Technologies ◽  
Everyday Practice ◽  
Structured Interviews ◽  
Manage Care ◽  
Age In Place ◽  
Care Services ◽  
People With Dementia ◽  
The Everyday

AbstractAssistive technologies (ATs) are being ‘mainstreamed’ within dementia care, where they are promoted as enabling people with dementia to age in place alongside delivering greater efficiencies in care. AT provision focuses upon standardised solutions, with little known about how ATs are used by people with dementia and their carers within everyday practice. This paper explores how people with dementia and carers use technologies in order to manage care. Findings are reported from qualitative semi-structured interviews with 13 people with dementia and 26 family carers. Readily available household technologies were used in conjunction with and instead of AT to address diverse needs, replicating AT functions when doing so. Successful technology use was characterised by ‘bricolage’ or the non-conventional use of tools or methods to address local needs. Carers drove AT use by engaging creatively with both assistive and everyday technologies, however, carers were not routinely supported in their creative engagements with technology by statutory health or social care services, making bricolage a potentially frustrating and wasteful process. Bricolage provides a useful framework to understand how technologies are used in the everyday practice of dementia care, and how technology use can be supported within care. Rather than implementing standardised AT solutions, AT services and AT design in future should focus on how technologies can support more personalised, adaptive forms of care.

scholarly journals The extended palliative phase of dementia – An integrative literature review

Dementia ◽  
2016 ◽  
Vol 18 (1) ◽  
pp. 108-134 ◽  
Author(s):  
Elizabeth Hanson ◽  
Amanda Hellström ◽  
Åsa Sandvide ◽  
Graham A Jackson ◽  
Rhoda MacRae ◽  
...  
Keyword(s):  
Literature Review ◽  
End Of Life Care ◽  
Dementia Care ◽  
Educational Opportunities ◽  
Advanced Dementia ◽  
Subsequent Work ◽  
People With Dementia ◽  
Definition Of ◽  
Palliative Phase ◽  
Person With Dementia

This article presents an integrative literature review of the experience of dementia care associated with the extended palliative phase of dementia. The aim was to highlight how dementia is defined in the literature and describe what is known about the symptomatology and management of advanced dementia regarding the needs and preferences of the person with dementia and their family carer/s. There was no consistent definition of advanced dementia. The extended palliative phase was generally synonymous with end-of-life care. Advanced care planning is purported to enable professionals to work together with people with dementia and their families. A lack of understanding of palliative care among frontline practitioners was related to a dearth of educational opportunities in advanced dementia care. There are few robust concepts and theories that embrace living the best life possible during the later stages of dementia. These findings informed our subsequent work around the concept, ‘Dementia Palliare’.

Ethical aspects in dementia care - The use of psychosocial interventions

2020 ◽  
pp. 096973302095212
Author(s):  
Benedicte Sørensen Strøm ◽  
Knut Engedal
Keyword(s):  
Psychosocial Interventions ◽  
Well Being ◽  
Dementia Care ◽  
Ethical Challenge ◽  
Ethical Aspects ◽  
Respect For Autonomy ◽  
Daily Care ◽  
People With Dementia ◽  
Clinical Practise ◽  
Person With Dementia

The use of psychosocial interventions for people with dementia is common and recommended because they focus on the underlying problem and well-being of the person. The promotion of well-being is a relevant dimension in person-centred care, where the aim is to confirm the person’s ‘personhood’. Most literature about ethics in dementia care instructs us on how and when to include people with dementia in our research. Little is written about the ethical aspects regarding the use of psychosocial interventions in daily care. In clinical practise, several challenges arise about the use of psychosocial interventions. Those include questions about the person’s ability to participate in decision-making and how we know what is best for them. Furthermore, we must consider what kinds of psychosocial interventions are best for everybody, or if intervention causes discomfort for the person. This article emphasizes the necessity to consider the ethical aspects of the implementation of psychosocial interventions while taking into consideration the persons individual needs. A particular ethical challenge arises when a person with dementia is unable to express themselves verbally. Therefore, it is essential that the staff know the history and preferences of each person with dementia. The ethical aspects of psychosocial interventions for people with dementia will be discussed using Beauchamp and Childress four ethical principles: respect for autonomy, beneficence, non-maleficence and justice. The person-centred approach proposed by Kitwood’s and Brooker.

scholarly journals 29 Adapting Dementia and Delirium Awareness Training to a Rehabilitation Setting

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Emma O'Brien ◽  
Monica Devine ◽  
Sarah Maxwell ◽  
Catherine McDonnell ◽  
Stuart Lee
Keyword(s):  
Cognitive Impairment ◽  
Occupational Therapy ◽  
Dementia Care ◽  
Awareness Training ◽  
Likert Scales ◽  
Staff Members ◽  
Patient Profile ◽  
People With Dementia ◽  
Adult Rehabilitation ◽  
The Impact

Abstract Background The patient profile in a Dublin rehabilitation hospital has changed in recent years to include older adult rehabilitation alongside orthopaedic rehabilitation. A snapshot audit completed by the occupational therapy department on one day in 2018 demonstrated that 64% of patients had an assessment score indicative of a cognitive impairment. A subjective gap in knowledge regarding dementia care and a misunderstanding of the ability of people with dementia to engage in rehabilitation was identified. It was imperative that dementia awareness training was provided with a particular focus on modifying rehabilitation techniques to cater for these patients. Methods A dementia care committee was established with an Educational Development subgroup responsible for addressing dementia and delirium awareness training. Educational material was received from the field of occupational therapy, nursing, medicine, pharmacy and dietetics. The programme was accredited by the Nursing and Midwifery Board of Ireland. A focus group was completed pre/post formulation of the presentation with various departmental representatives. Feedback provided was used to inform and finalise the training content. Results Sessions are completed once monthly. One hundred and seven participants to date have attended. Ten-point Likert scales are completed pre and post training. Data from the Likert scales were analysed revealing on average a 24.4 % increase in knowledge of dementia, a 27.6% increase in awareness of the impact of dementia on function and a 23.3% increase in confidence in caring for a patient with dementia. Highest contingent of staff members trained were household and catering staff (19%) nursing staff (18%), and health care attendants (13%). Conclusion This essential training is ongoing with thirty per cent of staff trained to date. The objective is for all staff to complete this training for enhanced care and rehabilitation for all patients with dementia. It will also aim to review treatment for all patients with cognitive impairment so unique rehabilitation programmes can be tailored.

scholarly journals Literature review: technological interventions and their impact on quality of life for people living with dementia

2020 ◽  
Vol 27 (1) ◽  
pp. e100064
Author(s):  
David Sanders ◽  
Philip Scott
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Dementia Care ◽  
Assistive Technologies ◽  
Healthcare Sector ◽  
Supporting Evidence ◽  
Technological Advancement ◽  
People With Dementia ◽  
Person With Dementia

ObjectivesRapid technology-driven innovation in the healthcare sector has led to an increasing ability to effectively respond to health challenges. However, the cognitive challenges faced by a person with dementia exacerbate the difficulty of designing enduring technological dementia care solutions. Despite this, and in the absence of a cure, facilitating well-being and improved quality of life becomes pivotal for those living with dementia and their caregivers. This review aimed to identify and consolidate the provision of technological solutions for dementia care, and how these are perceived to impact the quality of life of a person with dementia.MethodsArticles and journals were identified using keywords including those relating to quality of life, assistive technologies and technology adoption and acceptance. Greater priority was given to resources published after 2010 due to the speed of technological advancement, and peer-reviewed articles were preferred.Results91 resources were identified, with 38 contributing to the final review. In addition to multiple quality of life measurement tools, the literature identified a large variety of solutions that fell into three categories: those used ‘by’, ‘with’ or ‘on’ a person with dementia.ConclusionsThis review concludes that the ‘one size fits all’ approach to many solutions reflects the lack of supporting evidence, negatively impacting trust in their usefulness among caregivers and their subsequent adoption rates. This could be attributed to limited involvement of people with dementia in studies of effectiveness and adoption. Additional research is recommended to further consolidate research on quality of life and to understand the individuality and progression of dementia and its influence on dementia care solutions.

scholarly journals 305 - What happens before, during and after crisis for someone with dementia living at home

2020 ◽  
Vol 32 (S1) ◽  
pp. 62-63
Author(s):  
Sabarigirivasan Muthukrishnan ◽  
Jane Hopkinson ◽  
Kate Hydon ◽  
Lucy Young ◽  
Cristie Howells
Keyword(s):  
Hospital Admission ◽  
Social Care ◽  
Dementia Care ◽  
Home Treatment ◽  
List Type ◽  
Crisis Resolution ◽  
People With Dementia ◽  
Health And Social Care ◽  
Person With Dementia ◽  
At Home

Background:Best practice in dementia care is support in the home. Yet, crisis is common and can result in hospital admission. Home-treatment of crisis is an alternative to hospital admission that can have better outcomes and is the preference of people living with dementia.Purpose:To report an investigation of the management of crisis for people with dementia living at home and managed by a Home Treatment Crisis Team.Objective:To identify critical factors for successful resolution of crisis and avoidance of hospital admissionMethods:The research was mixed-methods case study design. It was an in depth investigation of what happens during crisis in people with dementia and how it is managed by a home treatment crisis team to resolution and outcome at six weeks and six months. Methods were observation of the management of crisis in the home setting for 15 people with dementia (max 3 per person, total 41 observations), interviews with people with dementia (n=5), carers (n=13), and 14 professionals (range 1 to 6 per person, total 29), a focus group with professionals (n=9) and extraction from medical records of demographics and medical history.The analysis focused on the identification of key treatments, behaviours, education and context important for home treatment to prevent hospital admission.Findings:The study recruited 15 of the 88 accepted referrals to the service for management of a crisis in a person with dementia.Factors key for crisis resolution were a systems approach with embedded respect for personhood,attention to carer needs independently of the person with dementia,review and monitoring of the effect of medications,awareness and promotion of potential benefits with treatment at home,education of the health and social care workforce in dementia care, local availability of respite and other social care services.The Home Treatment Crisis Team created a ‘Safe Dementia Space’ for the person with dementia in crisis. In the first instance, this was immediate but temporary with on-going assessment and intervention until negotiated permanent support was in place coproduced and agreed by stakeholders to be a sustainable dementia space with acceptable risk of harm to the person with dementia or others. The approach enabled avoidance of hospital admission in more than 80% of referrals.Conclusion:This is the first study to collect data during crisis at home for people with dementia and to investigate process and management. It reveals the Home Treatment Crisis Team created sustainable ‘Safe Dementia Space’ to enable the person with dementia to continue to live in the community during and after crisis, thus avoiding hospital admission. The identified key components of the management approach for crisis resolution are important considerations in the design and delivery of home treatment services for people with dementia in the UK and beyond.

scholarly journals Designing Dementia Care Pathways to Transform Non Dementia-Friendly Hospitals: Scoping Review

2021 ◽  
Vol 18 (17) ◽  
pp. 9296
Author(s):  
Jorge Riquelme-Galindo ◽  
Manuel Lillo-Crespo
Keyword(s):  
Cognitive Impairment ◽  
Scoping Review ◽  
Care Pathway ◽  
Dementia Care ◽  
Stressful Situation ◽  
Care Plans ◽  
Hospital Environments ◽  
People With Dementia ◽  
Centered Care ◽  
Core Elements

People with dementia (PwD) occupy around 25% of the hospital beds. Once PwD are admitted to hospitals, their cognitive impairment is not considered in most of the cases. Thus, it causes an impact on the development of the disease becoming a stressful situation as care plans are not adapted to PwD. The aim of this study was to explore the published core elements when designing a dementia care pathway for hospital settings. A scoping review was conducted to provide an overview of the available research evidence and identify the knowledge gaps regarding the topic. This review highlights person-centered care, compassionate care and end-of-life process as some of the key elements that should integrate the framework when designing a dementia care pathway. Architectonical outdoor and indoor hospital elements have also been found to be considered when adapting the healthcare context to PwD. Findings provide information about the key points to focus on to successfully design dementia interventions in hospital environments within available resources, mostly in those contexts in which national dementia plans are in its infancy. Hospitals should transform their patients’ routes and processes considering the increasing demographic changes of people with cognitive impairment.

A new model of care for patients with dementia: the Japanese initiative for dementia care

2017 ◽  
pp. 1027-1032
Author(s):  
Yohko Maki ◽  
Takashi Sakurai ◽  
Kenji Toba
Keyword(s):  
Long Term Care ◽  
Dementia Care ◽  
Community Members ◽  
Term Care ◽  
Ageing Society ◽  
People With Dementia ◽  
The World ◽  
Long Term Care Insurance ◽  
Person With Dementia

Facing the unprecedented ageing society, Japan’s contribution to the world should be to lead worldwide discussion on dementia care. This chapter introduces the Japanese initiatives for dementia care. For realization of a society where people with dementia live well, the new concept of ‘prosocial relationship-based care’ for dementia has been introduced as the ethical background; community members are expected to reach out helping hands to each person with dementia to restore their participation in society. Based on this basic concept and the long-term care insurance system, various measures related to primary, secondary and tertiary preventive approaches for dementia have been promoted to achieve appropriate and seamless coordination of medical and long-term care. To establish prosocial relationships, it is critical to promote cooperation among various stakeholders, and develop community networks and social resources.

scholarly journals Photo-Elicited Conversations about Therapy Dogs as a Tool for Engagement and Communication in Dementia Care: A Case Study

Animals ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. 820
Author(s):  
Lena Nordgren ◽  
Margareta Asp
Keyword(s):  
Sense Of Self ◽  
Dementia Care ◽  
Inner Life ◽  
Therapy Dog ◽  
Video Recordings ◽  
People With Dementia ◽  
Video Observations ◽  
Person With Dementia

Understanding the inner life of people with dementia can be challenging and there is a need for new and different approaches. Previous research shows that people with dementia can experience emotions such as harmony, closeness, and joy as well as sadness and concern when interacting with a therapy dog. Simultaneously, memories of past episodes are brought back to life when the person interacts with the dog. This raises questions about whether photos of interaction with a dog can evoke memories or support people with dementia in communicating emotions in a corresponding way. The aim of this study was to explore photo-elicited conversations as a tool for engagement and communication in dementia care. Repeated video observations of photo-elicited conversations between a woman with dementia and a dog handler/assistant nurse were used to collect data. The video recordings were analyzed with a phenomenological hermeneutical method. The role of photo-elicited conversations as a tool for engagement and communication in dementia care is that the conversations can help the person with dementia to feel a sense of being situated and recall feelings of liveliness and belongingness, and thus supporting the person’s sense of self. The results can be used to deepen nursing staff’s understanding of using photo-elicited conversations in dementia care.

Characteristics and Real-Life Outcomes of Dementia and Cognitive Impairment at a Geriatric Clinic

2020 ◽  
Vol 49 (3) ◽  
pp. 312-320
Author(s):  
Kritapas Chulakadabba ◽  
Weerasak Muangpaisan ◽  
Pitiporn Siritipakorn ◽  
Titima Wongviriyawong ◽  
Patumporn Suraarunsumrit ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Psychological Symptoms ◽  
Real Life ◽  
Retrospective Chart Review ◽  
Acetylcholinesterase Inhibitors ◽  
Dementia Care ◽  
Subjective Cognitive Decline ◽  
Geriatric Syndromes ◽  
People With Dementia ◽  
Geriatric Clinic

<b><i>Background:</i></b> Various patterns of dementia care have been developed in different settings, depending on the availability of healthcare resources and facilities. The purpose of this study was to examine the epidemiology and characteristics of dementia care at a geriatric clinic, a field that has been subject to little prior evaluation. <b><i>Methods:</i></b> A retrospective chart review was undertaken of cohort patients with cognitive impairment who had received a diagnosis and were still on active follow-up at a geriatric clinic. A total of 892 patients were included. In addition, 203 geriatric patients with no cognitive impairment who attended the clinic during the study period were sampled as a control. <b><i>Results:</i></b> The main diagnoses of dementia were Alzheimer’s disease (AD) (40.1%), vascular dementia (16.9%), unspecified dementia (16.3%), mixed dementia (9.0%), AD with cerebrovascular disease (8.7%), and Parkinson’s disease dementia (6.1%). Atypical dementia was presented in 3.0% of cases. There were 178 patients with mild cognitive impairment, 20 with vascular cognitive impairment, and 18 with subjective cognitive decline. Other comorbidities were found in 97% of the subjects. Patients with cognitive impairment had a higher total number of other geriatric syndromes and higher percentages for delirium, falls, immobility, loss of appetite, and incontinence. Potentially reversible causes of dementia were found in 11.3% of the cases. Acetylcholinesterase inhibitors were administered to 61%, whereas 23.5% received an NMDA receptor antagonist. The need for a change in the antidementia medication was identified for 10.7% of the subjects; the major cause was adverse drug side effects. Nonpharmacological therapy only was administered to 52.4% of the people with dementia who had behavioral and psychological symptoms. <b><i>Conclusions:</i></b> Mixed brain pathologies, comorbidities, and the coexistence of other geriatric syndromes are common at geriatric clinics. Holistic, integrated, and continuous care are needed to improve the outcomes of patients with more complicated comorbidities.

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